Risk Factors for Osteoporosis

Several factors can increase the likelihood of developing osteoporosis, including both genetic and lifestyle influences. Common risk factors include:

• Premature menopause or missing periods: A sharp decline in oestrogen levels during menopause accelerates bone loss, with women potentially losing up to 20% of their bone density within the first 5-7 years after menopause.
• Family history of osteoporosis: Genetics play a key role in bone health. Having a parent or sibling with osteoporosis increases your risk of developing it.
• Long-term steroid use, including inhalers for asthma: Prolonged use of corticosteroids can interfere with bone formation and increase bone loss.
• Previous history of fragility fractures: A fragility fracture is a break that occurs from a fall or trip from standing height or less. Experiencing such a fracture can indicate weakened bones, increasing the risk for future fractures.
• Thyroid medication or thyroid problems: Conditions like hyperthyroidism or taking medications for thyroid issues can negatively impact bone health by altering calcium and bone metabolism.
• History of eating disorders: Conditions such as anorexia or bulimia can affect bone health due to poor nutrition and nutrient deficiencies, particularly calcium and vitamin D.
• Breast cancer treatment: Certain treatments for breast cancer, such as chemotherapy or hormone therapy, can lead to bone loss by affecting oestrogen levels or reducing calcium absorption.
• Coeliac disease, digestive, and gastrointestinal disorders: Conditions like coeliac disease can interfere with nutrient absorption, particularly calcium and vitamin D, which are essential for bone health.

Who Should Have a Scan?

Osteoporosis can develop without obvious symptoms, so regular screening is important, especially for those at higher risk. You should consider getting a DXA bone density scan if you fall into any of the following categories:

• Women over 65 years of age
• Men over 70 years of age
• Postmenopausal women under 65 who have risk factors for osteoporosis (such as family history, prior fractures, or long-term steroid use)
• Individuals who have had a fracture from a trip or fall from a standing height or less (indicating weakened bones)

Important Information for Your DXA Scan:

• You should avoid having a DXA scan if you have had any imaging test involving contrast dye or barium (such as a CT scan or fluoroscopy) within the past 10 days.
• Please let the DXA Nurse know before the scan if there is any possibility you may be pregnant and/or breastfeeding.

Mobility Assistance:

• Please inform us in advance if you have any mobility issues or use a mobility aid.
• The DXA scan table is fixed in height and does not move up or down, so we may need to make special arrangements to ensure your comfort and safety during the scan.

Clothing Guidelines for Your DXA Scan:

• Please do not wear any clothing with metal, including zippers, metal buttons, bra fastenings, glittery fabrics, or belts. Metal can interfere with the accuracy of the scan.
• We recommend wearing loose, comfortable clothing without any metal components. If metal is present, we may not be able to proceed with your DXA scan.

What to Expect During Your DXA Scan:

You will be asked to remove any clothing or jewellery containing metal from the areas being scanned. During the scan, you will lie on your back on the scanning table while the arm of the machine passes over you. Typically, your lower back and both hips (provided no hip replacement) and a sideview of your spine will be scanned. In some cases, your non-dominant forearm will be scanned. It is important that you remain very still throughout the scan to ensure accurate results.

Which Areas Are Scanned and Why?

The DXA scan typically focuses on the spine and hips, as these are the regions most vulnerable to osteoporosis-related fractures.

• Spine: The spine is a common site for fractures in individuals with osteoporosis, particularly in the vertebrae, which can lead to severe pain and reduced mobility.
• Hips: Hip fractures are one of the most serious consequences of osteoporosis, often leading to long-term disability.
• In cases where a patient has artificial hip replacements, the forearm, where appropriate is scanned instead of the hips.

It’s important to note that nearly half of all women over the age of 50 will experience a fracture in one of these high-risk areas (hip, wrist, or spine) during their lifetime. Among those who fracture a hip, more than 50% of survivors may not be able to return to independent living.

Duration of the DXA Scan:

The DXA scan takes approximately 20 minutes to complete. Please allow a little extra time for preparation and positioning before the scan begins.

After Your DXA Scan:

There are no special precautions to follow after your scan. You may eat and drink as normal, drive, and return to work or your usual activities immediately if needed.

Receiving Your Results:

Your DXA scan will be reviewed and reported on by our consultant. The results will be sent directly to your referring doctor.

Please note that we do not discuss your scan results with you directly. Your GP or consultant will discuss the findings with you.

Radiation and Your DXA Scan:

We are all exposed to natural background radiation in our daily lives. Medical imaging, including DXA scans, adds only a small amount to this natural exposure.

The radiation dose from a DXA scan is very low—typically around 0.1 microsieverts (µSv), which is much less than most other types of medical imaging. DXA scans are accurate, quick, and considered very safe.

It is generally recommended to have a DXA scan every 2 years depending on your results and clinical risk factors.

Please note that a referral from your GP or consultant is required for each DXA scan.

Cost of a DXA Scan:

The cost for a DXA scan is as follows:

• €120.00 for private patients without a GMS Medical Card
• €100.00 for patients with a full GMS Medical Card
• No Charge under PCT GP Referral Scheme

Key Details of the PCT Referral Scheme:

• Eligibility:
  • Residents of County Mayo with a valid Medical/GP visit Card.
  • Referred by a GP to Mayo Medical Centre for a DXA bone density scan.
• Cost Coverage: The HSE will cover the full cost of the DXA scan for eligible patients.
• Waiting Period: As there are a limited number of PCT-funded DEXA scans available, there may be a longer waiting period for your scan. However, we are committed to ensuring that all eligible patients are accommodated.
• Referral Process: To benefit from this scheme, patients must:
  • Be referred by their GP in County Mayo.
  • Ensure they have a valid Medical/GP Visit Card.
  • Complete the patient form sent via SMS after the referral.

How to Access the PCT Referral Scheme:

1. Visit your GP: Schedule an appointment with your GP in County Mayo to discuss your eligibility and need for a DXA scan.
2. Referral: If appropriate, your GP will refer you to Mayo Medical Centre for a DXA scan under the PCT Referral Scheme.
3. Patient Form: After receiving the referral, you will receive a patient form via SMS to complete. This form must be filled out before the scan can take place.
4. Booking: Once the form is completed, your scan will be scheduled based on availability.

If you have any questions or need assistance with the referral process, please feel free to contact our admin team at Mayo Medical Centre. They will be happy to assist you with booking your scan or clarifying any details about the PCT Referral Scheme.

Health Insurance Coverage:

You will need to contact your health insurance provider to inquire whether your DXA scan is covered under your private health insurance plan.

Patient Form Requirement for Your DXA Scan:

We cannot proceed with your DXA scan until the patient form has been fully completed. The form will be sent to the mobile number provided on your GP/Consultant referral via SMS.

You can visit The Mayo Medical Centre in person to fill out the form. If you need any assistance, please feel free to contact our admin team on 094 90 20202 ext. 1, and they will be happy to help you complete it.

What Can I Do to Improve My Bone Density?

Maintaining and improving bone density is essential for preventing osteoporosis and fractures. Here are some keyways to support bone health:

1. Ensure Sufficient Intake of Calcium and Vitamin D
   • Calcium is essential for building and maintaining strong bones. Adults should aim for around 1000-1200 mg of calcium per day from food or supplements.
   • Vitamin D helps your body absorb calcium. It’s recommended to get about 800-1000 IU of vitamin D daily through sunlight exposure, diet (like fatty fish, egg yolks, and fortified foods), or supplements if needed.
2. Engage in Weight-Bearing Exercises
   
Weight-bearing activities, such as walking, jogging, dancing, and strength training, help stimulate bone growth and increase bone density. These exercises encourage the bones to bear weight, which improves their strength and resilience over time.
3. Limit Alcohol Consumption

   Excessive alcohol can interfere with calcium absorption and bone health. It’s best to drink in moderation—ideally no more than one drink per day for women and two drinks per day for men.
4. Quit Smoking
   
Smoking has been shown to weaken bone density and slow down the bone healing process. Quitting smoking is one of the most effective ways to reduce your risk of osteoporosis and related fractures.